[Hemophiliacs with HIV. Slower progression of the infection among younger patients and at higher dosages of factor concentrates].
HIV disease progression and the effect of replacement therapy with clotting factor concentrates (CFCs) were studied in 100 Swedish haemophiliacs, mean age at seroconversion 29 years (range, 4-72). On average 16 years after seroconversion, 67 per cent of the patients had CD4+ cell counts of < 200 x 10(6)/l, 50 per cent had developed AIDS, and 58 per cent had died. HIV disease progression was significantly slower in those aged less than 28 (median age) at seroconversion (P = 0.004). Moreover, mortality was inversely correlated to total annual CFC consumption after adjustment for age and HIV-related therapy, i.e., Pneumocystis carinii prophylaxis and antiretroviral drugs (P = 0.014), but unrelated to the purity of the CFCs used. After adjustment for age, annual CFC consumption and HIV-therapy, prophylactic replacement therapy was not associated with significantly better survival than on-demand treatment. It is concluded that in HIV-positive haemophiliacs replacement therapy may have a beneficial effect on the immune system, and that CFC purity and the regimen (prophylaxis vs on-demand) would seem to be factors of minor importance.
Astermark
J
J
avdelningen för koagulationssjukdomar, Universitetssjukhuset MAS, Malmö.
Berntorp
E
E
Stigendal
L
L
Johnsson
H
H
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000209:etiology; D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D017848:Blood-Borne Pathogens; D002648:Child; D002675:Child, Preschool; D005164:Factor IX / Q000008:administration & dosage / Q000009:adverse effects*; D005169:Factor VIII / Q000008:administration & dosage / Q000009:adverse effects*; D006679:HIV Seropositivity; D006467:Hemophilia A / Q000150:complications / Q000628:therapy* / Q000821:virology; D002836:Hemophilia B / Q000150:complications / Q000628:therapy* / Q000821:virology; D006801:Humans; D008875:Middle Aged
D005169:Factor VIII; D005164:Factor IX
Blödarsjuka med HIV. Långsammare infektionsförlopp hos yngre och vid större förbrukning av faktorkoncentrat.